Traumatic Injuries to Dentition Flashcards

Classification of Traumatic Injuries

• Ellis Classification (1940): Oldest classification for traumatic dental injuries, mainly referenced by physicians.
• Ellis Class I: Fracture confined to enamel.
• Ellis Class II: Fracture involving enamel and dentin.
• Ellis Class III: Fracture that includes pulp involvement.
• Ellis Class IV: Fracture affecting the root structure.
• WHO Classification: Comprehensive and widely accepted internationally; broader than Ellis but complex for daily use.
• Modified WHO Classification (Andreasen 1981): Comprehensive categorization of luxation injuries and dental tissue injuries.

Types of Injuries

• Injuries to Supporting Bone: Includes comminution and fractures of alveolar bone and jaw.
• Injuries to Gingiva or Oral Mucosa: Involves contusions, abrasions, and lacerations—lacerations may require suturing.
• Luxation Injuries: Categories include concussion, subluxation, extrusive, lateral, intrusive luxation, and avulsion.

Hard Dental Tissue Injuries

• Injuries to Hard Dental Tissue: Enamel infarction, uncomplicated (Ellis Class II) and complicated crown fractures, crown-root fractures, and root fractures.

Epidemiology and Etiology

• Traumatic Dental Injuries: Affect approximately 25-30% of adults in the USA; lower incidence in children (1-3%).
• Age Vulnerability: Most prevalent in ages 8-12 years; rare after 30; common in 16-30 during leisure or alcohol-related activities.
• Common Types of Oral Injuries: Predominantly dental injuries (92%); fractures of enamel/dentin without pulp involvement are most frequent.

Risk Factors and Prognosis

• Etiological Factors: Include falls, fights, sports, accidents, epilepsy, Battered Syndrome, and malocclusion (overjet risk).
• Pulp Vitality Prediction: Injury type affects survival; teeth with immature apices have better chances of regaining vitality post-trauma.

Diagnostic and Follow-Up Procedures

• SOAP Protocol: Documentation framework including subjective complaints, objective examination, assessment, and treatment planning.
• Pulp Vitality Testing: Requires cautious interpretation; false negatives common initially; true vitality responses can be delayed.
• Follow-Up Examination: Essential for monitoring outcomes over an extended period; various recalls recommended based on timing after injury.

Long-term Sequelae

• Common Sequelae: Pulp necrosis, canal obliteration, and external root resorption (less responsiveness to tests).
• Concussion: Mild injury with high pulp survival rates; no displacement of the tooth.
• Subluxation: Abnormal mobility without displacement; high chances of pulp survival for both open and closed apices.
• Luxation Types:
  • Extrusive luxation involves partial displacement; survival varies with apex maturity.
  • Lateral luxation causes directional displacement and socket fracture; survival prognosis decreases with closed apices.
  • Intrusive luxation results in tooth displacement into bone, severely affecting pulp survival.
  • Avulsion denotes complete tooth displacement; survival chances are minimal with prolonged time out of socket but improve with immediate reimplantation.

Explore the various classifications of traumatic injuries to the dentition with a focus on Ellis classification. This quiz will help you understand the different classes of dental fractures, from enamel to pulp involvement. Ideal for dental students and professionals seeking to enhance their knowledge in endodontics.